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  • Writer's pictureCatherine Lott

Treating bulimia with CBT

Updated: Jan 16, 2023





  • What Is Bulimia?

  • What Is Cognitive Behavioural Therapy ?

  • How Is Cognitive Behavioural Therapy Used to Treat Bulimia?

Bulimia is a severe and potentially life-threatening eating disorder. It often remains undetected for years as individuals can maintain an average or above-average weight while still having bulimia.


Many people who seek treatment for bulimia are between the ages of thirty and fifty when it has become entrenched. It's important to remember that no matter how long you've been struggling, recovery is always possible.


The most effective evidence-based treatment treatment for bulimia is Cognitive Behavioural Therapy or CBT.


What Is Bulimia?

Bulimia or bulimia nervosa is an eating disorder where you have episodes of uncontrolled eating or bingeing. Bingeing is defined as eating larger and out-of-control amounts of food than you would typically in a very short amount of time. After bingeing, you then purge either by misusing laxatives or by vomiting. Bulimia is an eating disorder characterized by regular, often secretive bouts of overeating followed by self-induced vomiting or purging, strict dieting, or extreme exercise, associated with persistent and excessive concern with body weight.

The two types of bulimia are:

  • Purging bulimia. This type of bulimia involves vomiting by choice, laxatives, diuretics, enemas, or other medications.

  • Non purging bulimia. If someone has this type of bulimia, they engage in behaviour, like fasting or excessive exercise instead of purging.

Regardless of the type of bulimia, it is an extremely disruptive and consuming disorder. It can also be life-threatening and present some serious physical consequences, some of which are:

  • Stomach rupture

  • Heart problems

  • Dental problems

  • Inflamed oesophagus

  • Swollen glands near cheeks

  • Irregular menstrual cycles

  • Kidney problems

  • Lessened sex drive

  • Addiction and compulsive behaviours

  • Mental health issues

  • Suicidal thoughts or behaviours

Due to bulimia’s far-reaching and grave consequences, it is important that you get help if you believe that you or a loved one is struggling with bulimia.



What Is Cognitive Behavioural Therapy?

Cognitive behavioural therapy is a type of psychological treatment used for various mental health issues and addictions. CBT is evidence-based, which means it has been widely studied, experienced, and documented. It has even been proven to be as or more effective than other types of therapies and medications.

CBT is ultimately based on several core principles. These include:

  • Psychological issues stem from unhelpful thoughts.

  • Unhelpful learned behavioral patterns cause psychological problems.

  • People who have psychological problems can get better by learning to cope with their problems and developing better strategies for dealing with them.


Typically, CBT involves first learning to recognize these patterns, understanding the problems, and then working with your therapist to repattern your thoughts and feelings around them. While certain things do need to be told about a patient’s past, typically, you will focus on your present with your therapist to learn how to move forward into the future in a more healthy way.


More recently CBT-E has been developed for the treatment of all eating disorders; cbte is the abbreviation for “enhanced cognitive behaviour therapy”, and is one of the most effective treatments for eating disorders. It is a “transdiagnostic” treatment for all forms of eating disorder including anorexia nervosa, bulimia nervosa, binge eating disorder and other similar states​.


How Is Cognitive Behavioural Therapy Used to Treat Bulimia?

To start with, CBT treatment for bulimia will be focused on disrupting the cycle of eating, bingeing, and then purging. Then therapy shifts to challenge the ideas and beliefs that underpin the eating disorder. At the end of each session, your therapist usually assigns homework. The homework is usually a mix of self-awareness exercises and experiments or tests to try between therapy sessions.

Usually, clients also are asked to keep a log of how they think and feel. This logging helps you understand that your eating disorder takes place in the much broader context of your mental state. For example, you may see trends in what triggers engaging in bulimia. As a result, you can start to become aware of your behavioural patterns.

Becoming aware of the mechanisms that allow an eating disorder to continue can give you freedom. You can learn to recognize, name, and then interrupt your patterns. Some of these patterns or cognitive distortions are:

  • All-or-nothing thinking

  • Thinking that you can read other people’s minds

  • Emotional rather than rational thinking

  • Personalization

These various cognitive distortions are difficult to dismantle. It can take quite a while to get rid of them. As a result, clients are often asked to collect a lot of data to support and deny their beliefs. That way, when you recognize your thoughts and feelings as a part of your eating disorder, you are armed with effective arguments against it and can work towards better and healthier habits instead.



Are you concerned that you or someone you love is struggling with bulimia? get in touch today talk about how we can help you




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